Beulah Roopavathana, NitinPaul Ambrose, SamuelJoseph Arthur, Anoop Paul, K Senthilnathan, Negine Paul, Suchita Chase, Bijesh Yadav, Antony Augustine
Background: In surgically high-risk patients with acute cholecystitis (AC), percutaneous cholecystostomy (PC) is an effective procedure. This study aimed to study the clinical outcomes of PC and to assess predictors for recurrence following PC placement. Methodology: A retrospective data review of all patients who underwent a PC for AC between 2010 and 2020 was performed. Results: Seventy-one patients underwent a PC with a mean age of 61.35 years (standard deviation: 14.11); 59 (83.1%) were male; 32 (45.1%) were the American Society of Anesthesiologists III and IV. Forty (56.3%) patients had multiple comorbid illnesses; 70 (98.6%) patients had Grade 2, 3 cholecystitis. All patients had ultrasound-guided drainage; 63 (88.7%) had transhepatic route. The mean duration till PC removal was 51.58 (1–313) days. Eleven (15.5%) patients developed recurrence after PC placement over a median of 40 (29–102) days; 6 (54.5%) were managed nonoperatively, 3 (27%) underwent laparoscopic cholecystectomy, and 2 (18%) developed cholangitis. After index admission with AC managed by PC, thirty-nine (54.9%) patients underwent cholecystectomy; 4(5.6%) at the index admission, 35 (49.3%) elective interval cholecystectomies. The rate of conversion to open at interval cholecystectomy among patients with no recurrence in the interval period was 31.88% (7/22), and 50% for patients with recurrent AC. Five (7.04%) patients had mortality at the index admission, and the overall 1-year mortality was 8.45% (6/71). Conclusion: A high clinical success rate and less procedure-related morbidity make PC a favorable procedure in surgically high-risk patients. Patients with a recurrent episode of AC were found to have higher rates of conversion at interval cholecystectomy. No specific predictor for recurrence was identified.
{"title":"Clinical outcomes of a percutaneous cholecystostomy for acute cholecystitis – A tertiary center experience","authors":"Beulah Roopavathana, NitinPaul Ambrose, SamuelJoseph Arthur, Anoop Paul, K Senthilnathan, Negine Paul, Suchita Chase, Bijesh Yadav, Antony Augustine","doi":"10.4103/cmi.cmi_54_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_54_23","url":null,"abstract":"Background: In surgically high-risk patients with acute cholecystitis (AC), percutaneous cholecystostomy (PC) is an effective procedure. This study aimed to study the clinical outcomes of PC and to assess predictors for recurrence following PC placement. Methodology: A retrospective data review of all patients who underwent a PC for AC between 2010 and 2020 was performed. Results: Seventy-one patients underwent a PC with a mean age of 61.35 years (standard deviation: 14.11); 59 (83.1%) were male; 32 (45.1%) were the American Society of Anesthesiologists III and IV. Forty (56.3%) patients had multiple comorbid illnesses; 70 (98.6%) patients had Grade 2, 3 cholecystitis. All patients had ultrasound-guided drainage; 63 (88.7%) had transhepatic route. The mean duration till PC removal was 51.58 (1–313) days. Eleven (15.5%) patients developed recurrence after PC placement over a median of 40 (29–102) days; 6 (54.5%) were managed nonoperatively, 3 (27%) underwent laparoscopic cholecystectomy, and 2 (18%) developed cholangitis. After index admission with AC managed by PC, thirty-nine (54.9%) patients underwent cholecystectomy; 4(5.6%) at the index admission, 35 (49.3%) elective interval cholecystectomies. The rate of conversion to open at interval cholecystectomy among patients with no recurrence in the interval period was 31.88% (7/22), and 50% for patients with recurrent AC. Five (7.04%) patients had mortality at the index admission, and the overall 1-year mortality was 8.45% (6/71). Conclusion: A high clinical success rate and less procedure-related morbidity make PC a favorable procedure in surgically high-risk patients. Patients with a recurrent episode of AC were found to have higher rates of conversion at interval cholecystectomy. No specific predictor for recurrence was identified.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134884275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AwatifKhamis Alsarrai Al-Alawi, Mahmood Al-Noufali, Darpanarayan Hazra, AmalNasser Al Shibli
Objectives: The prevalence of burnout is progressively rising among medical students. The objective of this study was to evaluate the occurrence and determinants of burnout among preclinical medical students in Muscat. Methods: This cross-sectional analytical research was conducted at one of Oman's top medical universities from October 2019 to April 2020. A cohort of 350 preclinical medical students in their 2nd, 3rd, and 4th years of study participated in this study. The assessment of burnout was based on self-reports from the participants, using the Maslach Burnout Inventory-Student Survey. Various variables were coded and analyzed. Results: A total of 350 students completed the survey (response rate: 83.3%). Burnout was reported by 125 (35.7%) students. Regarding specific domains of burnout, most students demonstrated higher rates of cynicism (n: 236; 67.4%) and emotional exhaustion (n: 221; 63.1%) and lower rates of academic efficacy (n: 197; 56.3%). Burnout was significantly more common among older students (p-value < 0.001), students living apart from their family (p-value: 0.042), students who did not participate in regular exercises (p-value < 0.001), those who spent fewer hours studying per day (p-value < 0.001), those who regretted their decision to study medicine (p-value: 0.023), those who were dissatisfied with examination results (p-value < 0.001), teaching strategies (p-value: 0.029), those with lower cumulative grade point averages (p-value < 0.001), and those with a history of academic probation (p-value < 0.001). Conclusions: Preclinical medical students displayed high rates of burnout. Continuous evaluation programs and educational initiatives are recommended to help such students to develop better burnout management and coping strategies.
{"title":"Burnout in preclinical medical students: Exploring factors and solutions – Muscat's story","authors":"AwatifKhamis Alsarrai Al-Alawi, Mahmood Al-Noufali, Darpanarayan Hazra, AmalNasser Al Shibli","doi":"10.4103/cmi.cmi_83_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_83_23","url":null,"abstract":"Objectives: The prevalence of burnout is progressively rising among medical students. The objective of this study was to evaluate the occurrence and determinants of burnout among preclinical medical students in Muscat. Methods: This cross-sectional analytical research was conducted at one of Oman's top medical universities from October 2019 to April 2020. A cohort of 350 preclinical medical students in their 2nd, 3rd, and 4th years of study participated in this study. The assessment of burnout was based on self-reports from the participants, using the Maslach Burnout Inventory-Student Survey. Various variables were coded and analyzed. Results: A total of 350 students completed the survey (response rate: 83.3%). Burnout was reported by 125 (35.7%) students. Regarding specific domains of burnout, most students demonstrated higher rates of cynicism (n: 236; 67.4%) and emotional exhaustion (n: 221; 63.1%) and lower rates of academic efficacy (n: 197; 56.3%). Burnout was significantly more common among older students (p-value < 0.001), students living apart from their family (p-value: 0.042), students who did not participate in regular exercises (p-value < 0.001), those who spent fewer hours studying per day (p-value < 0.001), those who regretted their decision to study medicine (p-value: 0.023), those who were dissatisfied with examination results (p-value < 0.001), teaching strategies (p-value: 0.029), those with lower cumulative grade point averages (p-value < 0.001), and those with a history of academic probation (p-value < 0.001). Conclusions: Preclinical medical students displayed high rates of burnout. Continuous evaluation programs and educational initiatives are recommended to help such students to develop better burnout management and coping strategies.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134884619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chest X-ray is a vital screening tool used in the emergency department for patients with the features of COVID-19 when awaiting virological real-time reverse transcription polymerase chain reaction results. It aids in early recognition and early initiation of therapy. Chest X-rays may reveal a range of abnormalities, from typical findings like bilateral ground-glass densities to more uncommon ones like pneumomediastinum. Here, we report a case series of four patients with COVID-19 of moderate severity and their chest X-ray findings.
{"title":"Chest X-ray findings in moderate cases of COVID-19","authors":"MathewVarghese Nellimootil, GokulPrakash Mahendra Sekar, GraceRebecca Polavarapu, ElakiaKulothunga Sozhan","doi":"10.4103/cmi.cmi_68_23","DOIUrl":"https://doi.org/10.4103/cmi.cmi_68_23","url":null,"abstract":"Chest X-ray is a vital screening tool used in the emergency department for patients with the features of COVID-19 when awaiting virological real-time reverse transcription polymerase chain reaction results. It aids in early recognition and early initiation of therapy. Chest X-rays may reveal a range of abnormalities, from typical findings like bilateral ground-glass densities to more uncommon ones like pneumomediastinum. Here, we report a case series of four patients with COVID-19 of moderate severity and their chest X-ray findings.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135212051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kumari, Anuja Abraham, Kavitha Abraham, P. Navaneethan, R. Karuppusami, S. Sridhar, A. Regi
Aim: The aim of this study was to assess the components of cardiotocography (CTG) during labor to identify the variables associated with the risk of adverse perinatal outcomes and to ascertain the mode of delivery in these women. Materials and Methods: This prospective observational study included 191 women at term with singleton pregnancy in labor. The CTG findings including baseline heart rate, accelerations, beat-to-beat variability, and type and severity of decelerations were noted as per the International Federation of Gynecology and Obstetrics classification and grouped into Category II or III patterns as per the National Institute of Child Health and Human Development classification. Low APGAR score, cord PH <7, neonatal intensive care unit admission, respiratory distress, and hypoxic-ischemic encephalopathy were considered adverse neonatal outcomes. Results: Persistent fetal tachycardia, poor beat-to-beat variability, and severe variable deceleration showed a significant association with adverse neonatal outcome and delivery by cesarean section (P < 0.05). Adverse neonatal outcomes were noted in 4.2% of babies and 40.9% of babies born to mothers whose CTG was categorized as II and III patterns, respectively (P < 0.001). Birth by cesarean section was significantly different between those with Category II and Category III patterns, 33.7% and 65.4%, respectively (P < 0.01). Conclusion: Reduction in the beat-to-beat variability and presence of severe variable decelerations are independent risks for adverse neonatal outcomes, irrespective of the category of CTG pattern. Category III fetal heart rate pattern shows a significant association with adverse outcomes and risk of cesarean delivery. Grading the Category II patterns may help in identifying variables that are truly associated with acidemia and further research into this is recommended.
{"title":"Intrapartum electronic fetal monitoring and perinatal outcomes: Analysis of components of fetal heart rate pattern","authors":"M. Kumari, Anuja Abraham, Kavitha Abraham, P. Navaneethan, R. Karuppusami, S. Sridhar, A. Regi","doi":"10.4103/cmi.cmi_75_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_75_22","url":null,"abstract":"Aim: The aim of this study was to assess the components of cardiotocography (CTG) during labor to identify the variables associated with the risk of adverse perinatal outcomes and to ascertain the mode of delivery in these women. Materials and Methods: This prospective observational study included 191 women at term with singleton pregnancy in labor. The CTG findings including baseline heart rate, accelerations, beat-to-beat variability, and type and severity of decelerations were noted as per the International Federation of Gynecology and Obstetrics classification and grouped into Category II or III patterns as per the National Institute of Child Health and Human Development classification. Low APGAR score, cord PH <7, neonatal intensive care unit admission, respiratory distress, and hypoxic-ischemic encephalopathy were considered adverse neonatal outcomes. Results: Persistent fetal tachycardia, poor beat-to-beat variability, and severe variable deceleration showed a significant association with adverse neonatal outcome and delivery by cesarean section (P < 0.05). Adverse neonatal outcomes were noted in 4.2% of babies and 40.9% of babies born to mothers whose CTG was categorized as II and III patterns, respectively (P < 0.001). Birth by cesarean section was significantly different between those with Category II and Category III patterns, 33.7% and 65.4%, respectively (P < 0.01). Conclusion: Reduction in the beat-to-beat variability and presence of severe variable decelerations are independent risks for adverse neonatal outcomes, irrespective of the category of CTG pattern. Category III fetal heart rate pattern shows a significant association with adverse outcomes and risk of cesarean delivery. Grading the Category II patterns may help in identifying variables that are truly associated with acidemia and further research into this is recommended.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"43 1","pages":"26 - 30"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78663944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Praveen G. Paul, Beena Kingsbury, Hilda Yenuberi, R. Tirkey, S. Benjamin, S. Rathore, Babuji Manimegalai, A. Belavendra, J. Mathews
Introduction: Follow-up of the mothers and their offspring recruited to a randomized controlled trial comparing neonatal outcomes in women with gestational diabetes treated with metformin or glibenclamide was conducted 9 years ago. A significant decrease in neonatal hypoglycemia in the group treated with metformin was seen in the original study. Methodology: Results of clinical examination, blood sample collection, and dual-energy X-ray absorptiometry (DEXA) scan not published in a brief communication are described in this study. The nutritional status was assessed using a 3-day recall method using the Indian Food Composition Table 2017. The physical activity of offspring was assessed using the Global Physical Activity Questionnaire. Results: The overall follow-up rate of the cohort was 49% and similar in both the groups. The anthropometric details, blood tests, and DEXA in the women and their offspring were similar except that the offspring of the group on metformin had higher triglyceride values than the offspring of the women treated with glibenclamide. The average body mass index of the offspring was similar and was 18. Currently, women who were treated with glibenclamide 9 years ago had higher fasting plasma glucose levels (9.2 [7.3, 12.6]) than the metformin group (7.2 [6.1, 8.4] median [interquartile range]), P = 0.02. They also had significantly higher diastolic blood pressure readings 77.1mmHg (8.9) and 72.1mmHg (11.7) mean (SD), P = 0.035. (Information from the previously published brief communication). Conclusion: No significant adverse outcome was seen in women treated with metformin and the offspring 9 years later.
9年前，一项随机对照试验对接受二甲双胍或格列本脲治疗的妊娠期糖尿病妇女的新生儿结局进行了随访。在最初的研究中，二甲双胍治疗组新生儿低血糖显著降低。方法:临床检查、血样采集和双能x线吸收仪(DEXA)扫描的结果未在简短的通讯中发表。根据2017年印度食品成分表，采用3天召回法评估营养状况。使用全球身体活动问卷对后代的身体活动进行评估。结果:队列总体随访率为49%，两组随访率相近。除了二甲双胍组的后代的甘油三酯值高于格列本脲组的后代外，这些妇女及其后代的人体测量细节、血液测试和DEXA相似。后代的平均体重指数相似，均为18。目前，9年前接受格列本脲治疗的女性空腹血糖水平(9.2[7.3,12.6])高于二甲双胍组(7.2[6.1,8.4]中位数[四分位数范围])，P = 0.02。他们的舒张压读数也显著升高，平均77.1mmHg(8.9)和72.1mmHg (11.7)， P = 0.035。(资料来自先前公布的简短来文)。结论:二甲双胍治疗的妇女及其后代9年后未见明显不良结局。
{"title":"The study of offspring and mothers with gestational diabetes treated with metformin or glibenclamide in a randomized controlled trial after 9 years","authors":"Praveen G. Paul, Beena Kingsbury, Hilda Yenuberi, R. Tirkey, S. Benjamin, S. Rathore, Babuji Manimegalai, A. Belavendra, J. Mathews","doi":"10.4103/cmi.cmi_95_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_95_22","url":null,"abstract":"Introduction: Follow-up of the mothers and their offspring recruited to a randomized controlled trial comparing neonatal outcomes in women with gestational diabetes treated with metformin or glibenclamide was conducted 9 years ago. A significant decrease in neonatal hypoglycemia in the group treated with metformin was seen in the original study. Methodology: Results of clinical examination, blood sample collection, and dual-energy X-ray absorptiometry (DEXA) scan not published in a brief communication are described in this study. The nutritional status was assessed using a 3-day recall method using the Indian Food Composition Table 2017. The physical activity of offspring was assessed using the Global Physical Activity Questionnaire. Results: The overall follow-up rate of the cohort was 49% and similar in both the groups. The anthropometric details, blood tests, and DEXA in the women and their offspring were similar except that the offspring of the group on metformin had higher triglyceride values than the offspring of the women treated with glibenclamide. The average body mass index of the offspring was similar and was 18. Currently, women who were treated with glibenclamide 9 years ago had higher fasting plasma glucose levels (9.2 [7.3, 12.6]) than the metformin group (7.2 [6.1, 8.4] median [interquartile range]), P = 0.02. They also had significantly higher diastolic blood pressure readings 77.1mmHg (8.9) and 72.1mmHg (11.7) mean (SD), P = 0.035. (Information from the previously published brief communication). Conclusion: No significant adverse outcome was seen in women treated with metformin and the offspring 9 years later.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"215 1","pages":"50 - 56"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76538132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Raina, A. Chandra, W. Dar, Hilal Ganie, Zubair Kawaja, Maqbool Wani, Ravouf Asimi
Background: Cerebral venous sinus thrombosis (CVST) accounts for 10%–20% of strokes in young persons. In India, CVST accounts for around 30% of all strokes. The majority of CVSTs are caused by procoagulant circumstances, with pregnancy and early puerperium being well-established risk factors. The study aimed to look into the clinical profile, radiological characteristics, etiological variables, and outcome of CVST in venous stroke patients admitted to a tertiary care facility. Methods: We included individuals between the ages of 18 and 75 years who had a cerebral venous thrombosis (CVT) diagnosis confirmed by magnetic resonance imaging (MRI) + magnetic resonance venography computed tomography (CT) plus CT venography. The research included all individuals suspected of having CVST with or without particular neurological deficits and a confirmed imaging diagnosis. Patients were removed in situations of ambiguous neuroimaging, arterial strokes, space-occupying lesions, metabolic encephalopathy, and patient reluctance to participate. Results: This study included 82 patients, 21 (25.6%) males and 61 (74.4%) of whom were females. The most common presenting symptom was headache (79.2%), followed by vomiting (54.8%) and abnormal sensorium (35.3%). In this study, 34/82 (41.4%) patients had evident clinical triggers and were classified as induced CVT. Para infectious disease was recognized as a risk factor for CVT in 13/34 (38.2%) patients. A prothrombotic conditions could be established in 48 (58.5%) of these patients. Conclusion: CVST is a treatable and reversible cause of stroke in adolescents. The clinical presentation varies greatly, and symptoms may appear gradually over weeks or months. Although it is still an uncommon cause of headache and stroke, MRI has allowed for early detection.
{"title":"Clinicoetiological profile of cerebral venous sinus thrombosis patients at a tertiary care center","authors":"A. Raina, A. Chandra, W. Dar, Hilal Ganie, Zubair Kawaja, Maqbool Wani, Ravouf Asimi","doi":"10.4103/cmi.cmi_111_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_111_22","url":null,"abstract":"Background: Cerebral venous sinus thrombosis (CVST) accounts for 10%–20% of strokes in young persons. In India, CVST accounts for around 30% of all strokes. The majority of CVSTs are caused by procoagulant circumstances, with pregnancy and early puerperium being well-established risk factors. The study aimed to look into the clinical profile, radiological characteristics, etiological variables, and outcome of CVST in venous stroke patients admitted to a tertiary care facility. Methods: We included individuals between the ages of 18 and 75 years who had a cerebral venous thrombosis (CVT) diagnosis confirmed by magnetic resonance imaging (MRI) + magnetic resonance venography computed tomography (CT) plus CT venography. The research included all individuals suspected of having CVST with or without particular neurological deficits and a confirmed imaging diagnosis. Patients were removed in situations of ambiguous neuroimaging, arterial strokes, space-occupying lesions, metabolic encephalopathy, and patient reluctance to participate. Results: This study included 82 patients, 21 (25.6%) males and 61 (74.4%) of whom were females. The most common presenting symptom was headache (79.2%), followed by vomiting (54.8%) and abnormal sensorium (35.3%). In this study, 34/82 (41.4%) patients had evident clinical triggers and were classified as induced CVT. Para infectious disease was recognized as a risk factor for CVT in 13/34 (38.2%) patients. A prothrombotic conditions could be established in 48 (58.5%) of these patients. Conclusion: CVST is a treatable and reversible cause of stroke in adolescents. The clinical presentation varies greatly, and symptoms may appear gradually over weeks or months. Although it is still an uncommon cause of headache and stroke, MRI has allowed for early detection.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"11 1","pages":"14 - 18"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75196267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Osunde, C. Nwozichi, O. Olorunfemi, J. Sodimu, O. Olorunfemi
Background: Low back pain (LBP) is a major problem in the nursing profession and it is been reported that more nurses experience LBP during the nursing practice. Studies show that only 15.9% of nurses had LBP before coming into nursing while 84.5% complained they had LBP after working in the nursing environment. Aim: The aim of this study was to determine factors responsible for low back ache, as related to the work environment in the University of Benin Teaching Hospital, Benin City, Nigeria. Materials and Methods: A cross-sectional descriptive study was conducted from January 2019 to February 2020, with probability sampling to select a sample size (n = 260). Data collected were analyzed using tables; percentages, bivariate analysis, and and multivariate logistic regression were used for data analysis at 0.05 level of significance, through a statistical package for the social science software. Results: Among 260 nurses with backache, 159 (61.15%) were male and most of the participants' ages were between 25 and 34 years, with a mean age of 26.5 (0.37). The multivariate logistic regression analysis showed that heavy manual lifting (odd ratio [OR] 0.21, 95% confident interval [CI] 0.54–0.73), body posture (OR 0.31, 95% CI 0.20–1.08), the length of working shift (OR 0.60, 95% CI 0.74–0.86), awkward postures (OR 0.68, 95% CI 0.65–1.10), and prolonged standing during nursing care (OR 0.73, 95% CI 0.52–1.00) were the major factors for LBP among nurses, with <0.001, 0.001, 0.002, 0.002, and 0.003, respectively. Conclusions: The finding implies that all effort should be directed toward policies which have positive effects on proper management of the work environment and other conditions, such as health and safety training. Prevention of work overloads through appropriate work shifting, and the mechanism of body posture should be improved. Furthermore, periodical flexing of feet, knees, and hip is necessary in a condition where there is a need to stand for a long period of time.
背景:腰痛是护理专业的一个主要问题，据报道，越来越多的护士在护理实践中经历过腰痛。研究表明，只有15.9%的护士在进入护理行业前有过腰痛，而84.5%的护士在进入护理行业后有过腰痛。目的:本研究的目的是确定导致腰痛的因素，与工作环境有关，在贝宁市贝宁大学教学医院，尼日利亚。材料与方法:于2019年1月至2020年2月进行横断面描述性研究，采用概率抽样选择样本量(n = 260)。收集的数据使用表格进行分析;通过社会科学软件的统计软件包，采用百分比、双变量分析和多变量逻辑回归进行数据分析，显著性水平为0.05。结果:260例腰痛护士中，男性159例(61.15%)，年龄以25 ~ 34岁为主，平均年龄26.5岁(0.37岁)。多因素logistic回归分析显示，重体力搬运(奇数比[OR] 0.21, 95%可信区间[CI] 0.54 ~ 0.73)、体位(OR 0.31, 95% CI 0.20 ~ 1.08)、工作时长(OR 0.60, 95% CI 0.74 ~ 0.86)、笨拙体位(OR 0.68, 95% CI 0.65 ~ 1.10)、站立时间过长(OR 0.73, 95% CI 0.52 ~ 1.00)是影响护士腰痛的主要因素，差异分别<0.001、0.001、0.002、0.002、0.003。结论:这一发现表明，所有努力都应针对对工作环境和其他条件的适当管理产生积极影响的政策，例如健康和安全培训。通过适当的工作班次预防工作超载，并改善身体姿势的机制。此外，在需要长时间站立的情况下，定期弯曲脚、膝盖和臀部是必要的。
{"title":"Low back pain among nurses as related to work environment: A cross-sectional observational study","authors":"N. Osunde, C. Nwozichi, O. Olorunfemi, J. Sodimu, O. Olorunfemi","doi":"10.4103/cmi.cmi_46_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_46_22","url":null,"abstract":"Background: Low back pain (LBP) is a major problem in the nursing profession and it is been reported that more nurses experience LBP during the nursing practice. Studies show that only 15.9% of nurses had LBP before coming into nursing while 84.5% complained they had LBP after working in the nursing environment. Aim: The aim of this study was to determine factors responsible for low back ache, as related to the work environment in the University of Benin Teaching Hospital, Benin City, Nigeria. Materials and Methods: A cross-sectional descriptive study was conducted from January 2019 to February 2020, with probability sampling to select a sample size (n = 260). Data collected were analyzed using tables; percentages, bivariate analysis, and and multivariate logistic regression were used for data analysis at 0.05 level of significance, through a statistical package for the social science software. Results: Among 260 nurses with backache, 159 (61.15%) were male and most of the participants' ages were between 25 and 34 years, with a mean age of 26.5 (0.37). The multivariate logistic regression analysis showed that heavy manual lifting (odd ratio [OR] 0.21, 95% confident interval [CI] 0.54–0.73), body posture (OR 0.31, 95% CI 0.20–1.08), the length of working shift (OR 0.60, 95% CI 0.74–0.86), awkward postures (OR 0.68, 95% CI 0.65–1.10), and prolonged standing during nursing care (OR 0.73, 95% CI 0.52–1.00) were the major factors for LBP among nurses, with <0.001, 0.001, 0.002, 0.002, and 0.003, respectively. Conclusions: The finding implies that all effort should be directed toward policies which have positive effects on proper management of the work environment and other conditions, such as health and safety training. Prevention of work overloads through appropriate work shifting, and the mechanism of body posture should be improved. Furthermore, periodical flexing of feet, knees, and hip is necessary in a condition where there is a need to stand for a long period of time.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"5 1","pages":"9 - 13"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72765188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The association between thyroid dysfunction and electrolyte imbalance may result in significant morbidity. The present study was conducted to evaluate the effect of hypothyroidism on serum potassium levels in an urban female population of Eastern India. Materials and Methods: The present study was conducted in a peripheral Medical College in West Bengal for 12 months after taking Institutional Ethical Clearance and informed consent of the participants. One hundred and fifty hypothyroid females were included in the study group and one hundred participants were included as a control. The participants of both groups were age-matched. Serum thyroid-stimulating hormone (TSH) and free thyroxine 4 (FT4) levels were estimated by the enzyme-linked immunosorbent assay method and serum potassium was estimated by ion-selective electrode. Unpaired t-test and correlation coefficient were used for the analysis of data. Results: Hypokalemia was observed in 23 participants among the 150 hypothyroid females included in the study (15.33%). There was a significant difference in TSH (P < 0.00001), FT4 (P < 0.00001), and potassium levels (P = 0.000031) between the study and control groups. Serum potassium levels were strongly negatively correlated with TSH levels (r = −0.7356, P < 0.00001), the R2 value of 54.11%, and positively correlated with FT4 levels (r = 0.224, P = 0.005859). Conclusions: 15.33% of hypothyroid females included in the study had hypokalemia and serum potassium levels were significantly less in hypothyroid females as compared to euthyroid controls and serum potassium levels were negatively correlated with TSH levels. Serum electrolyte estimation may be of considerable importance in the management of hypothyroid individuals and needs to be considered and may help to prevent further possible complications.
{"title":"A study to evaluate the outcomes of hypothyroidism on serum potassium levels in an urban female population of Eastern India","authors":"Samarjit Koner, A. Chaudhuri","doi":"10.4103/cmi.cmi_62_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_62_22","url":null,"abstract":"Background: The association between thyroid dysfunction and electrolyte imbalance may result in significant morbidity. The present study was conducted to evaluate the effect of hypothyroidism on serum potassium levels in an urban female population of Eastern India. Materials and Methods: The present study was conducted in a peripheral Medical College in West Bengal for 12 months after taking Institutional Ethical Clearance and informed consent of the participants. One hundred and fifty hypothyroid females were included in the study group and one hundred participants were included as a control. The participants of both groups were age-matched. Serum thyroid-stimulating hormone (TSH) and free thyroxine 4 (FT4) levels were estimated by the enzyme-linked immunosorbent assay method and serum potassium was estimated by ion-selective electrode. Unpaired t-test and correlation coefficient were used for the analysis of data. Results: Hypokalemia was observed in 23 participants among the 150 hypothyroid females included in the study (15.33%). There was a significant difference in TSH (P < 0.00001), FT4 (P < 0.00001), and potassium levels (P = 0.000031) between the study and control groups. Serum potassium levels were strongly negatively correlated with TSH levels (r = −0.7356, P < 0.00001), the R2 value of 54.11%, and positively correlated with FT4 levels (r = 0.224, P = 0.005859). Conclusions: 15.33% of hypothyroid females included in the study had hypokalemia and serum potassium levels were significantly less in hypothyroid females as compared to euthyroid controls and serum potassium levels were negatively correlated with TSH levels. Serum electrolyte estimation may be of considerable importance in the management of hypothyroid individuals and needs to be considered and may help to prevent further possible complications.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"4 1","pages":"235 - 239"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82458606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Over the past couple of decades, medical education has transformed extensively and a number of curricular reforms have been introduced. Lectures have been regarded as one of the teaching–learning methods, which have been with us for decades together, and have been adopted as one of the key strategies by the teachers to pass knowledge to students. In general, an effective lecture should aim to attain three goals, namely to impart useful information, introduce some kind of curiosity among students so that they decide about learning on their own, and provide practical relevance. Even though the lecture is being widely used, owing to their inherent limitations, their use as a solitary method of teaching–learning has been discouraged by the educators and regulatory bodies. To conclude, the lecture method in medical education has its own pros and cons. However, considering the advantages attributed to lectures and the presence of strategies that can be incorporated to eliminate the pitfalls in lectures, at present, lecture methods can be still continued for medical education delivery. Nevertheless, we have to make the lecture sessions interactive and ensure that students indulge in active learning, and this essentially calls for faculty development programs.
{"title":"Lecture at crossroads in medical education: Is it time to say goodbye or introduce specific strategies to enhance their effectiveness?","authors":"S. Shrivastava, P. Shrivastava","doi":"10.4103/cmi.cmi_50_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_50_22","url":null,"abstract":"Over the past couple of decades, medical education has transformed extensively and a number of curricular reforms have been introduced. Lectures have been regarded as one of the teaching–learning methods, which have been with us for decades together, and have been adopted as one of the key strategies by the teachers to pass knowledge to students. In general, an effective lecture should aim to attain three goals, namely to impart useful information, introduce some kind of curiosity among students so that they decide about learning on their own, and provide practical relevance. Even though the lecture is being widely used, owing to their inherent limitations, their use as a solitary method of teaching–learning has been discouraged by the educators and regulatory bodies. To conclude, the lecture method in medical education has its own pros and cons. However, considering the advantages attributed to lectures and the presence of strategies that can be incorporated to eliminate the pitfalls in lectures, at present, lecture methods can be still continued for medical education delivery. Nevertheless, we have to make the lecture sessions interactive and ensure that students indulge in active learning, and this essentially calls for faculty development programs.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"1 1","pages":"259 - 261"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87791395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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